Q: Dr. Eppley, I am interested in enhanced fat injections, but was told by a doctor that it was no longer allowed but see you are discussing it so you must be using it. I have a couple questions. I had a lumpectomy nine months ago with radiation. Can not get implants so I am looking at fat injections to fill the hole and add some volume as my beasts are quite small. Is this a procedure you would recommend for someone in very good health and 69 years old? Can injections be done on my other breast to increase volume?
A: The term ‘enhanced’ fat injections can have various meanings. Some use the term to simply refer to liposuction-harvested fat that is concentrated and then injected. Other interpretations refer to actually adding a stimulant to concentrated fat such as PRP (platelet-rich plasma), stem cells or even insulin. I prefer to use this latter definition of enhanced fat injections as adding something to the concentrated fat.
Currently no one really knows if adding any agent to concentrated fat is helpful in creating better fat survival but it remains biologically appealing. The addition of stem cells to fat is the most intriguing and captures the greatest public interest. But the harvesting of stem cells, growing them in cell culture and putting them back into a patient is not presently permitted by the FDA unless it is part of a sponsored clinical study. (as no one knows what such concentrates of stem cells will really do) Fat, by its composition, already has a lot of stem cells so every fat injection is technically already ‘enhanced’ to some degree.
Since the addition of extra stem cells is not permitted, I prefer to add PRP to smaller volume fat injections. PRP is an extract of your own blood that contains platelets which are full of various growth factors. These have well known stimulant properties on wound healing, take a few minutes during the procedure to harvest and concentrate and are easily mixed in with fat.
Fat injections are an excellent treatment for lumpectomy defects particularly in tissues that have received radiation, regardless of the patient’s age. While fat can also be injected into breasts for general volume enhancement, the success of that breast augmentation approach depends on what your breast currently look like and what result you are expecting to achieve.
Dr. Barry Eppley